LOGAN HEALTH - CONRAD: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- LOGAN HEALTH - CONRAD (EIN 81-0232406)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-11-14
- IRS object ID
- 201423189349307267
- Schema version
- 2013v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2014-11-14T14:51:49-06:00 | ReturnTs |
| Tax Period End | 2013-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 450250958 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EIDE BAILLY LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 NICOLLET MALL STE 1300 | AddressLine1 |
| City | MINNEAPOLIS | City |
| State | MN | State |
| ZIP Code | 554027033 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 810232406 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PONDERA MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | POND | BusinessNameControlTxt |
| Phone | 4062713211 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 805 SUNSET BLVD | AddressLine1 |
| City | CONRAD | City |
| State | MT | State |
| ZIP Code | 59425 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BILL O'LEARY | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 4062713211 | PhoneNum |
| Signature | 2014-11-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KIM HUNWARDSEN CPA | PreparerPersonNm |
| PTIN | P00484560 | PTIN |
| Phone | 6122536500 | PhoneNum |
| Preparation | 2014-11-12 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | BILL O'LEARY | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 805 SUNSET BLVD | AddressLine1 |
| City | CONRAD | City |
| State | MT | State |
| ZIP Code | 59425 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $12,510,910 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.PONDERAMEDICAL.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1975 | FormationYr |
| Legal Domicile State | MT | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE ACCESS TO QUALITY HEALTH CARE THROUGH ALL LIFE'S STAGES | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 291 | TotalEmployeeCnt |
| Total Volunteers | 150 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $928,120 | PYContributionsGrantsAmt |
| CY Contributions Grants | $460,050 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $13,203,666 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $12,010,409 | CYProgramServiceRevenueAmt |
| PY Investment Income | $28,089 | PYInvestmentIncomeAmt |
| CY Investment Income | $37,442 | CYInvestmentIncomeAmt |
| PY Other Revenue | $8,808 | PYOtherRevenueAmt |
| CY Other Revenue | $3,009 | CYOtherRevenueAmt |
| PY Total Revenue | $14,168,683 | PYTotalRevenueAmt |
| CY Total Revenue | $12,510,910 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $8,206,499 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $8,158,011 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $5,168,154 | PYOtherExpensesAmt |
| CY Other Expenses | $4,592,164 | CYOtherExpensesAmt |
| PY Total Expenses | $13,374,653 | PYTotalExpensesAmt |
| CY Total Expenses | $12,750,175 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $794,030 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$239,265 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $6,666,200 | TotalAssetsBOYAmt |
| Total Assets EOY | $6,126,065 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,873,767 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,553,657 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $3,792,433 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $3,572,408 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | AS AN ESSENTIAL MEMBER OF OUR REGIONAL COMMUNITY, PMC STRIVES TO BE A PROGRESSIVE HEALTHCARE BUSINESS DEVOTED TO PROVIDING ACCESS TO QUALITY HEALTHCARE AND EXCEEDING THE EXPECTATIONS OF THOSE WE SERVE THROUGH ALL OF LIFE'S STAGES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $7,942,570 | ExpenseAmt |
| Revenue | $7,008,500 | RevenueAmt |
| Desc | PONDERA MEDICAL CENTER IS A 25-BED CRITICAL ACCESS HOSPITAL. THE MEDICAL CENTER PROVIDED 277 PATIENT DAYS ALONG WITH A 24-HOUR EMERGENCY ROOM THAT ACCOUNTED FOR 1,891 VISITS FOR THE YEAR. OUTPATIENT SERVICES SUCH AS LAB, X-RAY, PHYSICAL AND OCCUPATIONAL THERAPY, WELLNESS CENTER, SURGERY, AMBULANCE, CARDIAC REHAB, DME, HOME HEALTH AND RESPIRATORY THERAPY WERE PROVIDED TO MEMBERS OF OUR RURAL COMMUNITY SO THEY COULD RECEIVE THE SERVICES THEY NEEDED CLOSE TO HOME. THE SERVICES ARE ESSENTIAL FOR THE SURVIVAL OF OUR COMMUNITY.THE MEDICAL CENTER MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE IT PROVIDES. THESE RECORDS INCLUDE THE AMOUNT OF CHARGES FOREGONE FOR SERVICES AND SUPPLIES FURNISHED UNDER ITS CHARITY CARE POLICY AND EQUIVALENT SERVICE STATISTICS. THE AMOUNTS OF CHARGES FOREGONE FOR SERVICES PROVIDED UNDER THE MEDICAL CENTER'S CHARITY CARE POLICY WAS $88,033. TOTAL DIRECT AND INDIRECT COSTS RELATED TO THESE FOREGONE CHARGES WERE APPROXIMATELY $81,000 AT DECEMBER 31, 2013, BASED ON AVERAGE RATIOS OF COST TO GROSS CHARGES.THE MEDICAL CENTER PROVIDES CARE TO PATIENTS AND RESIDENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. BECAUSE THE MEDICAL CENTER DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS PATIENT AND RESIDENT SERVICE REVENUE. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,525,545 | ExpenseAmt |
| Revenue | $3,357,227 | RevenueAmt |
| Desc | PONDERA MEDICAL CENTER'S EXTENDED CARE FACILITY IS A 59-BED NURSING HOME OFFERING 24-HOUR CARE AND NURSING SERVICES PROVIDED BY LICENSED, CERTIFIED AND COMPASSIONATE STAFF MEMBERS. THE FACILITY HAD 18,945 TOTAL PATIENT DAYS. STAFF-TO-RESIDENT RATIO IS 1 TO 4. SPECIALIZED SERVICES ARE ALSO AVAILABLE INCLUDING THOSE OFFERED BY A PHYSICAL THERAPIST, OCCUPATIONAL THERAPIST, REGISTERED DIETITIAN, AND MEDICAL SOCIAL WORKER. WE HAVE A REMARKABLE ACTIVITY PROGRAM. ACTIVITIES ARE OFFERED 7 DAYS A WEEK AND INCLUDE EXERCISE, SOCIALS, GAMES, THEME PARTIES, PETS, GARDENING, COOKING, LIVE MUSIC, CRAFTS AND OUTINGS.WE HAVE A 14-BED SPECIAL CARE UNIT DESIGNATED FOR RESIDENTS WITH PERVASIVE MEMORY LOSS AND CONFUSION, PROVIDING AN EXTRA TOUCH OF ATTENTION AND SUPERVISION. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,397,594 | ExpenseAmt |
| Revenue | $1,644,682 | RevenueAmt |
| Desc | PONDERA MEDICAL CENTER CLINIC IS A FAMILY PRACTICE RURAL HEALTH CLINIC DEDICATED TO PROVIDING AND COORDINATING COMPREHENSIVE SERVICES TO THE ENTIRE FAMILY. OUR PHYSICIANS ARE BOARD CERTIFIED FAMILY PRACTITIONERS, WITH EXPERIENCE IN OBSTETRICS. BOARDED FAMILY PRACTICE PHYSICIANS MUST COMPLETE AN ADDITIONAL THREE YEARS OF SPECIALIZED TRAINING ABOVE AND BEYOND THAT OF MEDICAL SCHOOL. FAMILY PRACTITIONERS ARE TRAINED IN ALL AVENUES OF MEDICINE, SO THEY CAN PROVIDE A FULL RANGE OF CARE. PMCC PHYSICIAN ASSISTANTS ARE LICENSED BY THE STATE OF MONTANA AND SPECIALIZE IN FAMILY MEDICINE AND URGENT CARE. OUR PROVIDERS PROMOTE HEALTHY LIFESTYLES AND CONTINUALLY STRENGTHEN THE RELATIONSHIP BETWEEN THE CLINIC AND COMMUNITY, WITH EXCELLENT, TIMELY, AND COMPASSIONATE PATIENT CARE. THE CLINIC HAS 2 PHYSICIANS AND 2 PHYSICIAN ASSISTANTS AND PROVIDED 11,420 TOTAL CLINIC VISITS, 408 EXTENDED CARE VISITS AND 114 SWING BED VISITS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $10,865,709 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | Yes (1) | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 30 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 291 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | 0 | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BRENDA RIES | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4062713211 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 805 SUNSET BLVD | AddressLine1 |
| City | CONRAD | City |
| State | MT | State |
| ZIP Code | 59425 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| BRENT GAYLORD | |||||||
| CHAIR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JAYNE GOLLEHON | |||||||
| VICE CHAIR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| KARLA STYREN | |||||||
| SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| BERNARD RIES | |||||||
| TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| TED KRONEBUSCH | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| CHERYL BAKKEN | |||||||
| TRUSTEE (PARTIAL YEAR) | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JANICE HOPPES | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| CARLA HAUK | |||||||
| TRUSTEE (TERMINATED 2013) | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| GENA MORRIS | |||||||
| TRUSTEE (PARTIAL YEAR) | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| KELLY GREER | |||||||
| TRUSTEE (PARTIAL YEAR) | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| WAYNE OGBURN | |||||||
| CEO | 40.00 | Yes (X) | $64,135 | $0 | $6,348 | ||
| BRENDA RIES | |||||||
| INTERIM CFO | 40.00 | Yes (X) | $85,230 | $0 | $5,490 | ||
| RANDY NIGHTENGALE | |||||||
| CFO (PARTIAL YEAR) | 40.00 | Yes (X) | $0 | $0 | $0 | ||
| MICHAEL HEWETT | |||||||
| PHYSICIAN ASSISTANT | 36.00 | $129,345 | $0 | $0 | Yes (X) | ||
| ILENE HAWKINSON | |||||||
| PHYSICIAN ASSISTANT | 40.00 | $115,778 | $0 | $266 | Yes (X) | ||
| PATRICIA GRENA | |||||||
| PHYSICIAN | 40.00 | $164,258 | $0 | $14,545 | Yes (X) | ||
| PATRICK ALDUENDA | |||||||
| PHYSICIAN ASSISTANT | 40.00 | $138,870 | $0 | $0 | Yes (X) | ||
| JAY TAYLOR | |||||||
| PHYSICIAN | 40.00 | $231,334 | $0 | $19,024 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $928,950 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $45,673 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 8 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| CPSI | |||||
| 6600 WALL ST | MOBILE | AL | 36695 | SOFTWARE SUPPORT SERVICES | $437,898 |
| KALISPELL MEDICAL CENTER | |||||
| 310 SUNNY VIEW LANE | KALISPELL | MT | 59901 | LAB PROFESSIONAL STAFF, RADIOLOGY | $315,095 |
| HILL ANESTHESIA PC | |||||
| PO BOX 1006 | CONRAD | MT | 59425 | ANESTHESIA SERVICES | $143,817 |
| GE HEALTHCARE FINANCIAL SERVICES | |||||
| PO BOX 641419 | PITTSBURGH | PA | 15264 | CT MACHINE MAINTENANCE | $102,414 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $277,373 | GovernmentGrantsAmt |
| All Other Contributions | $182,677 | AllOtherContributionsAmt |
| Total Contributions | $460,050 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 622110 | $8,245,785 | $8,245,785 |
| NURSING HOME | 623000 | $3,357,227 | $3,357,227 |
| BED TAX REVENUE | 900099 | $232,860 | $232,860 |
| SUPPORTING REVENUE | 900099 | $124,427 | $124,427 |
| EHR INCENTIVE | 900099 | $48,650 | $48,650 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,460 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,460 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $12,010,409 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $36,942 | TotalRevenueColumnAmt |
| Exclusion | $36,942 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $3,009 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $3,009 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,009 | TotalRevenueColumnAmt |
| Exclusion | $3,009 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $500 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $500 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $500 | TotalRevenueColumnAmt |
| Exclusion | $500 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $12,510,910 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $12,010,409 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $40,451 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $161,203 | TotalAmt |
| Management And General | $161,203 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,794,073 | TotalAmt |
| Program Services | $6,043,182 | ProgramServicesAmt |
| Management And General | $750,891 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,000 | TotalAmt |
| Program Services | $1,779 | ProgramServicesAmt |
| Management And General | $221 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $658,828 | TotalAmt |
| Program Services | $586,013 | ProgramServicesAmt |
| Management And General | $72,815 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $541,907 | TotalAmt |
| Program Services | $471,597 | ProgramServicesAmt |
| Management And General | $70,310 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $199,774 | TotalAmt |
| Program Services | $199,774 | ProgramServicesAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,456 | TotalAmt |
| Management And General | $9,456 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,700 | TotalAmt |
| Management And General | $34,700 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,117,135 | TotalAmt |
| Program Services | $794,284 | ProgramServicesAmt |
| Management And General | $322,851 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,456 | TotalAmt |
| Program Services | $4,691 | ProgramServicesAmt |
| Management And General | $18,765 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $724,799 | TotalAmt |
| Program Services | $617,303 | ProgramServicesAmt |
| Management And General | $107,496 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $185,474 | TotalAmt |
| Program Services | $55,445 | ProgramServicesAmt |
| Management And General | $130,029 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $280,030 | TotalAmt |
| Program Services | $270,468 | ProgramServicesAmt |
| Management And General | $9,562 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,926 | TotalAmt |
| Program Services | $20,648 | ProgramServicesAmt |
| Management And General | $278 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,068 | TotalAmt |
| Program Services | $28,019 | ProgramServicesAmt |
| Management And General | $6,049 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53,654 | TotalAmt |
| Program Services | $53,654 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $654,689 | TotalAmt |
| Program Services | $654,689 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $189,840 | TotalAmt |
| Management And General | $189,840 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| BAD DEBT EXPENSE | $340,013 | $340,013 |
| MEDICAL SUPPLIES | $326,793 | $326,793 |
| FOOD | $225,013 | $225,013 |
| MT BED TAX | $172,344 | $172,344 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,750,175 | TotalAmt |
| Program Services | $10,865,709 | ProgramServicesAmt |
| Management And General | $1,884,466 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $967,673 | BOYAmt |
| EOY | $774,934 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,165,565 | BOYAmt |
| EOY | $1,195,616 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $135,653 | BOYAmt |
| EOY | $124,054 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $67,765 | BOYAmt |
| EOY | $49,305 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $12,421,269 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $9,815,858 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,127,372 | BOYAmt |
| EOY | $2,605,411 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $447,590 | BOYAmt |
| EOY | $466,830 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,836 | BOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $747,746 | BOYAmt |
| EOY | $909,915 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,666,200 | BOYAmt |
| EOY | $6,126,065 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,601,933 | BOYAmt |
| EOY | $1,713,352 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,081,322 | BOYAmt |
| EOY | $716,385 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $89,367 | BOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $101,145 | BOYAmt |
| EOY | $123,920 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,873,767 | BOYAmt |
| EOY | $2,553,657 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,224,869 | BOYAmt |
| EOY | $1,135,080 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,567,564 | BOYAmt |
| EOY | $2,437,328 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,792,433 | BOYAmt |
| EOY | $3,572,408 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,666,200 | BOYAmt |
| EOY | $6,126,065 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$239,265 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $19,240 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 0 | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | Yes (1) | AgentTrusteeEtcInd |
| Beginning Balance | $5,500 | BeginningBalanceAmt |
| Additions During Year | $8,340 | AdditionsDuringYearAmt |
| Distributions During Year | $9,037 | DistributionsDuringYearAmt |
| Ending Balance | $4,803 | EndingBalanceAmt |
| Incl Escrow Custodial Acct Liab | 0 | InclEscrowCustodialAcctLiabInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $48,854 | OtherCostOrOtherBasisAmt |
| Book Value | $48,854 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,261,782 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,689,730 | DepreciationAmt |
| Book Value | $1,572,052 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,909,413 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,975,144 | DepreciationAmt |
| Book Value | $934,269 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $201,220 | OtherCostOrOtherBasisAmt |
| Depreciation | $150,984 | DepreciationAmt |
| Book Value | $50,236 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $2,605,411 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INVESTMENT IN PERPETUAL TRUST | Desc |
| Book Value | $466,830 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $466,830 | TotalBookValueSecuritiesAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| OTHER ASSETS | $62,662 |
| ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS | $338,683 |
| WORKER'S COMPENSATION DEPOSIT | $122,328 |
| OTHER ACCOUNTS RECEIVABLE | $386,242 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $909,915 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | COMPENSATED ABSENCES | Desc |
| Amt | $123,920 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $123,920 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $11,966,213 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | -$374,427 | OtherRevenueAmt |
| Revenue Not Reported | -$374,427 | RevenueNotReportedAmt |
| Revenue Subtotal | $12,340,640 | RevenueSubtotalAmt |
| Other Revenues Not Included | $170,270 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $170,270 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $12,510,910 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $12,356,508 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $12,356,508 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $393,667 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $393,667 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $12,750,175 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART IV, LINE 1B: | THE FUNDS ARE THE PERSONAL FUNDS OF THE NURSING HOME RESIDENTS AND ARE TO BE USED ONLY FOR SPECIFIC PERSONAL EXPENDITURES AS REQUESTED BY THE RESIDENTS. |
| PART X, LINE 2: | THE MEDICAL CENTER IS ORGANIZED AS A MONTANA NONPROFIT CORPORATION AND HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE (IRS) AS EXEMPT FROM FEDERAL INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). THE MEDICAL CENTER IS ANNUALLY REQUIRED TO FILE A RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990) WITH THE IRS. THE MEDICAL CENTER BELIEVES THAT IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN AFFECTING ITS ANNUAL FILING REQUIREMENTS, AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. THE MEDICAL CENTER WOULD RECOGNIZE FUTURE ACCRUED INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS AND LIABILITIES IN INCOME TAX EXPENSE IF SUCH INTEREST AND PENALTIES ARE INCURRED. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE RECORDED IN REVENUE FOR FINANCIAL STATEMENTS -340,013. INTEREST EXPENSE RECORDED IN NON-OPERATING REVENUE FOR FINANCIAL STATEMENTS -53,654. GAIN ON PERPETUAL TRUST RECORDED IN NON-OPERATING REVENUE FOR FINANCIAL STMT 19,240. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | CAPITAL GRANTS AND RESTRICTED CONTRIBUTIONS RECORDED IN REVENUE FOR FORM 990 170,270. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE RECORDED IN TOTAL EXPENSES FOR FORM 990 340,013. INTEREST EXPENSE RECORDED IN TOTAL EXPENSES FOR FORM 990 53,654. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 175.000000000000 | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Care Medically Indigent | 0 | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $81,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $81,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00650 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $81,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $81,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00650 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,166,809 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,680,663 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,486,146 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11980 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,166,809 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,680,663 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,486,146 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11980 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,247,809 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,680,663 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,567,146 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.12630 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $340,013 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $2,426,310 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $2,438,538 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$12,228 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PONDERA MEDICAL CENTER | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 805 SUNSET BLVD | AddressLine1 |
| City | CONRAD | City |
| State | MT | State |
| ZIP Code | 59425 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.PONDERAMEDICAL.COM | WebsiteAddressTxt |
| State License | 13510 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | PROVIDER BASED RURAL HEALTH CLINIC | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PONDERA MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| CHNA Conducted | 0 | CHNAConductedInd |
| Organization Incur Excise Tax | Yes (1) | OrganizationIncurExciseTaxInd |
| Form4720 Filed | Yes (1) | Form4720FiledInd |
| Excise Report Form4720 For All | $50,000 | ExciseReportForm4720ForAllAmt |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (1) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | Yes (1) | FPGUsedDetermEligDscntCareInd |
| FPG Family Incm Lmt Dscnt Care | 175.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| Medicaid Medicare | Yes (X) | MedicaidMedicareInd |
| Other Factors | Yes (X) | OtherFactorsInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Lowest Negotiated Rates | Yes (X) | LowestNegotiatedRatesInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | Yes (1) | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PONDERA MEDICAL CENTER | PART V, SECTION B, LINE 12I: PONDERA MEDICAL CENTER UTILIZES THE FEDERAL POVERTY GUIDELINES (FPG) AS THE PRIMARY FINANCIAL MEASUREMENT TOOL. FINANCIAL DETERMINATION IS BASED ON FAMILY SIZE AND INCOME. ALL FORMS OF INCOME ARE CONSIDERED, INCLUDING BUT NOT LIMITED TO: WORKMAN'S COMPENSATION PAYMENTS, SOCIAL SECURITY BENEFITS, UNEMPLOYMENT WAGES, CHILD SUPPORT PAYMENTS, ETC. |
| PONDERA MEDICAL CENTER | PART V, SECTION B, LINE 14G: PATIENTS ARE INFORMED ABOUT THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE DURING CONVERSATIONS AT REGISTRATION AND DURING FOLLOW-UP ON OUTSTANDING ACCOUNT BALANCES. INFORMATION REGARDING FINANCIAL ASSISTANCE AND APPLICATIONS ARE AVAILABLE AT OUR BUSINESS OFFICE. THE FINANCIAL ASSISTANCE APPLICATION IS ALSO AVAILABLE ON OUR WEBSITE. |
| PONDERA MEDICAL CENTER | PART V, SECTION B, LINE 22: ALL INDIVIDUALS ELIGIBLE UNDER THE HOSPITAL FINANCIAL ASSISTANCE POLICY ARE PROVIDED A DISCOUNT FOR EMERGENCY AND OTHER MEDICALLY NECESSARY CARE. THE FINANCIAL ASSISTANCE POLICY DOES NOT APPLY TO ELECTIVE PROCEDURES. THEREFORE, FAP-ELIGIBLE PATIENTS WITHOUT INSURANCE MAY BE CHARGED GROSS CHARGES ON ELECTIVE PROCEDURES. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 4 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (4 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | FacilityFacilityTxt |
|---|---|---|---|---|
| PONDERA MED CTR EXTENDED CARE FACILITY | ||||
| 805 SUNSET BLVD | CONRAD | MT | 59425 | LONG TERM CARE |
| PONDERA MEDICAL CENTER EYE CLINIC PLLC | ||||
| 403 S DELAWARE ST | CONRAD | MT | 59425 | EYE CARE AND OPTICAL |
| PONDERA MED CTR DURABLE MEDICAL EQUIP | ||||
| 809 SUNSET BLVD | CONRAD | MT | 59425 | DURABLE MEDICAL EQUIPMENT |
| PONDERA MEDICAL CENTER HOME HEALTH | ||||
| 809 SUNSET BLVD | CONRAD | MT | 59425 | HOME HEALTH CARE |
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | CHARITY CARE EXPENSE WAS CONVERTED TO COST BASED ON AN OVERALL COST-TO-CHARGE RATIO ADDRESSING ALL PATIENT SEGMENTS. THE COST FOR SUBSIDIZED HEALTH SERVICES WAS DETERMINED USING THE MEDICARE COST REPORT. |
| PART I, LN 7 COL(F): | THE AMOUNT OF BAD DEBT EXPENSE REMOVED FROM TOTAL EXPENSES TO DETERMINE THE PERCENTAGE WAS $340,013. |
| PART III, LINE 4: | BAD DEBT EXPENSE IS REPORTED NET OF DISCOUNTS AND CONTRACTUAL ALLOWANCES. WE ARE USING THE BAD DEBT EXPENSE AS REPORTED ON THE FINANCIAL STATEMENTS. PAYMENTS ON ACCOUNTS PREVIOUSLY WRITTEN OFF TO BAD DEBT EXPENSE REDUCE BAD DEBT EXPENSE IN THE CURRENT YEAR. THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS CAN BE FOUND ON PAGE 8 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. |
| PART III, LINE 8: | TOTAL REVENUE RECEIVED FROM MEDICARE IS THE GROSS REIMBURSEMENT PLUS SETTLEMENT. BOTH TOTAL REVENUE RECEIVED FROM MEDICARE AND THE MEDICARE ALLOWABLE COSTS ARE REPORTED FROM THE MEDICARE COST REPORT. THE MEDICARE COST REPORT IS COMPLETED BASED ON THE RULES AND REGULATIONS SET FORTH BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES.THE MEDICARE SHORTFALL REPRESENTS A COST ABSORBED BY THE HOSPITAL AS A RESULT OF PROVIDING CARE TO MEDICARE PATIENTS. THE COST OF PROVIDING THIS BENEFIT TO THE COMMUNITY SHOULD BE REPORTED AS SUCH. |
| PART III, LINE 9B: | PATIENTS MUST COMPLETE A FINANCIAL ASSISTANCE APPLICATION TO BE CONSIDERED FOR CHARITY CARE. THOSE PATIENTS KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE OR THAT HAVE CONTACTED THE BUSINESS OFFICE AND ARE IN THE PROCESS OF COMPLETING AN APPLICATION OR SETTING UP A PAYMENT SCHEDULE WILL NOT RECEIVE ADDITIONAL COLLECTION NOTICES. |
| PART VI, LINE 2: | A COMMUNITY SURVEY WAS PREPARED AND ADMINISTERED BY AN INDEPENDENT THIRD PARTY. WE ALSO OBTAINED HEALTH FAIR REQUESTS AND RESULTS, PHYSICIAN STUDIES OF TRENDS AND PATIENT SATISFACTION SURVEYS. OUR COMMUNITY HEALTH NEEDS ASSESSMENT WAS DUE DECEMBER 31, 2013 AND WAS IN DRAFT FORM OF COMPLETION. THE FINAL REPORT AND AN IMPLEMENTATION STRATEGY WERE APPROVED BY THE BOARD IN 2014. |
| PART VI, LINE 3: | PATIENTS ARE INFORMED ABOUT THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE DURING CONVERSATIONS AT REGISTRATION AND DURING FOLLOW-UP ON OUTSTANDING ACCOUNT BALANCES. FINANCIAL ASSISTANCE IS OFFERED IF A PATIENT IS UNABLE TO MAKE A PAYMENT. |
| PART VI, LINE 4: | PONDERA MEDICAL CENTER SERVES THE POPULATION OF PONDERA COUNTY, MONTANA. THE POPULATION OF PONDERA COUNTY IN 2013 WAS 6,211 AND IS CONSIDERED RURAL. THE MEDIAN HOUSEHOLD INCOME FOR 2008 - 2012 WAS $39,223 IN WHICH 18.1% OF THE POPULATION WAS BELOW THE POVERTY GUIDELINES. THE RACIAL MAKEUP CONSISTS OF 82% WHITE, 15% AMERICAN INDIAN OR ALASKA NATIVE WITH THE REMAINDER BEING OTHER RACES. THE LARGEST INCOME PRODUCING SEGMENT OF PONDERA COUNTY IS AGRICULTURE AND WHILE THERE ARE A COUPLE LARGE EMPLOYERS IN THE COUNTY INCLUDING PONDERA MEDICAL CENTER, SMALL BUSINESS, AND OIL AND NATURAL GAS PRODUCERS MAKE UP THE MAJORITY OF EMPLOYERS. THE NEAREST HOSPITAL IS MARIAS MEDICAL CENTER, A 20-BED ACUTE CARE HOSPITAL LOCATED IN SHELBY, MT. MARIAS MEDICAL CENTER IS LOCATED APPROXIMATELY 27 MILES NORTH OF CONRAD, MT. |
| PART VI, LINE 5: | THE BOARD OF DIRECTORS IS COMPRISED OF COMMUNITY MEMBERS THROUGHOUT PONDERA COUNTY AND ALL BOARD MEETINGS ARE OPEN TO THE PUBLIC. SURPLUSES OF CASH, WHEN AVAILABLE, ARE INVESTED BACK INTO THE HOSPITAL FOR EQUIPMENT PURCHASES AND WAGE CONSIDERATIONS.PONDERA MEDICAL CENTER OPERATES AN EMERGENCY ROOM AVAILABLE TO ALL REGARDLESS OF ABILITY TO PAY, 20 ACUTE CARE BEDS FOR HOSPITAL STAYS, SURGERY CENTER, 59 BED EXTENDED CARE CENTER, SPECIAL CARE UNIT, RURAL HEALTH CLINIC, WELLNESS CENTER, CARDIAC REHAB, HOME HEALTH AGENCY, PHYSICAL THERAPY AND NUMEROUS OTHER SERVICES TO MEET YOUR DAILY AND LONG-TERM HEALTH CARE NEEDS. PONDERA MEDICAL CENTER SEEKS AND ENCOURAGES COMMUNITY MEMBERS TO BECOME INVOLVED AND VOLUNTEER IN OUR EXTENDED CARE FACILITY. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | Yes (1) | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PATRICIA GRENA | ||||||||||||||
| PHYSICIAN | $164,258 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $14,545 | $0 | $178,803 | $0 | $0 | $0 |
| JAY TAYLOR | ||||||||||||||
| PHYSICIAN | $231,334 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $19,024 | $0 | $250,358 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 5 | PROVIDERS RECEIVE ADDITIONAL INCOME BASED ON THEIR BILLED CHARGES AFTER ACHIEVING THEIR BASE AMOUNT. PHYSICIAN BONUS IS BASED ON GROSS REVENUE OVER $375,000; FOR EVERY $10,000 GROSS REVENUE IS OVER THE THRESHOLD THEY GET $5,000 BONUS COMPENSATION. THERE IS NO CAP ON THE AMOUNT OF BONUS ATTAINABLE. |
| SCHEDULE J, PART I, LINE 5A: | NO BONUSES WERE PAID DURING 2013. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 8B | THE ORGANIZATION DOES NOT HAVE COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 IS REVIEWED BY THE CEO AND CFO. AFTER THEIR REVIEW A DRAFT COPY OF THE 990 IS PROVIDED BY E-MAIL TO THE BOARD MEMBERS FOR REVIEW. THE FINAL COPY OF THE FORM 990 IS E-MAILED TO THE BOARD PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | OFFICERS AND TRUSTEES ANNUALLY DISCLOSE POTENTIAL CONFLICTS, WHICH ARE DISCUSSED AT A BOARD OF TRUSTEES MEETING. SEGREGATION OF DUTIES IS STRICTLY ENFORCED FOR ANY POTENTIAL FAMILY OR BUSINESS CONFLICTS OF INTEREST. IF THERE IS A POTENTIAL CONFLICT AT A BOARD MEETING, THE BOARD MEMBER IS NOT ALLOWED TO VOTE ON THE CONFLICTING ISSUE. |
| FORM 990, PART VI, SECTION B, LINE 15 | COMPENSATION IS DETERMINED ON AN ANNUAL BASIS BY THE BOARD OF TRUSTEES BY USING THE MONTANA HOSPITAL SALARY SURVEY FOR LIKE HOSPITALS IN THE STATE AND ADJUSTED FOR BUDGET LIMITATIONS. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART VII: | RANDY NIGHTENGALE WAS THE CFO PROVIDED BY KALISPELL AT THE END OF 2013 BUT WAS NOT COMPENSATED BY PONDERA MEDICAL CENTER UNTIL A MANAGEMENT AGREEMENT WAS ESTABLISHED IN 2014. |
| FORM 990, PART XI, LINE 9: | GAIN ON PERPETUAL TRUST 19,240. |
| FORM 990, PART XII, LINE 2C: | THE BOARD OF DIRECTORS IS RESPONSIBLE FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. |